Stroke

Stroke

What is a stroke?

Stroke is a cardiovascular disease that affects the blood vessels supplying blood to the brain. It is often called a “brain attack” because it is similar to a heart attack.

The brain needs oxygen and nutrients that are supplied by the blood. When a blockage occurs or when the vessel bursts, blood does not reach the brain cells. If brain cells are deprived of oxygen and nutrients for even a few minutes, they cannot work and will rapidly die. When the cells die, the part of the body they control will not work either. This can be devastating, because brain cells cannot be replaced.

• Stroke is the third leading cause of death in the U.S. behind high blood pressure and cancer.
• Every 45 seconds someone in the U.S. has a stroke and every three minutes, someone dies from a stroke.

Millions of stroke survivors struggle with disabilities in the aftermath of stroke. We now know that if a stroke victim receives emergency care within the first three to six hours of the first symptom, the disabling, long-term effects of stroke may be avoided or greatly reduced.

There are two main types of stroke:

• Ischemic Stroke: Seventy to 80 percent of all strokes are ischemic strokes. This occurs when a blood clot or other particle suddenly blocks blood flow in the artery and blood is unable to pass through the blockage. The area no longer receiving blood is said to be “ischemic” because it is no longer receiving the oxygen it needs.
• Hemorrhagic Stroke: This occurs when a blood vessel ruptures. While less common than ischemic strokes, this type of stroke has a higher mortality rate. In a hemorrhagic stroke, blood is unable to reach brain cells because of the rupture in the vessel. This will also reduce the oxygen supply to the brain tissue at that level. Due to the vast number of blood vessels in the brain, severity of injury and disability will vary depending on the location and type of blood vessel rupture.

There is also a third type of stroke called Transient Ischemic Attack (TIA), or “mini-stroke.” TIAs occur when a blood clot temporarily clogs an artery and that part of the brain does not get oxygen for a short period of time. Symptoms are often identical to a stroke but the difference is that a TIA lasts a short period of time and is then resolved. TIAs can indicate that an individual is more likely to have a stroke later and should be evaluated for stroke risk. A TIA should also be handled as a medical emergency. Anyone having a TIA should seek medical attention immediately.

What are the symptoms of stroke?

1. Sudden numbness or weakness: of the face, arm or leg, especially on the same side of the body.
2. Sudden confusion
3. Sudden difficulty speaking or understanding
4. Sudden trouble walking, dizziness or loss of balance
5. Sudden severe headache with no known cause

If you suspect someone is having a stroke:

• Call 911 - Consider it a medical emergency.
• Do not ignore signs of stroke, even if they seem to subside.
• Note the time symptoms began
• Seek emergency treatment immediately

What are some of the risk factors of stroke?

• High blood pressure
• Smoking
• Diabetes
• Peripheral vascular disease (PVD)
• Heart disease (CAD)
• Atherosclerosis
• High blood cholesterol
• Obesity
• Excessive alcohol
• Prior stroke, TIA or heart attack
• Stress
• Oral contraceptives

How is stroke diagnosed?

Through any of these four procedures, all of which are available at Mercy any time:

• Computerized Axial Tomography CT or CAT scan: uses x-rays to generate image of the brain
• Magnetic Resonance Imaging (MRI): uses a giant magnet to generate images
• Doppler Ultrasound: high frequency sound waves to detect blockages in the carotid artery
• Angiography: uses dye injection to create images of the major blood vessels of the brain

What treatment is available?

1. Within three hours of onset: medications called thrombolytics or “clot buster” drugs can be given to help break up the clot in the blood vessels of the brain for those patients with ischemic stroke.
2. Blood thinners: to help reduce the risk of further blood clots.
3. Cerebral angioplasty and/or stenting: still considered experimental, this option uses insertion of balloons, stents or coils in the damaged or blocked vessels, or carotid (neck) or cerebral (head) arteries.
4. Carotid endarterectomy: surgical removal of plaque blocking blood flow in the carotid artery in the neck
5. Rehabilitation: successful rehabilitation depends on the extent of the injury, attitude of both the survivor and rehabilitation team, and cooperation of family and friends

Mercy provides all of these treatments through its Emergency Department, Katz Cardiovascular Center and Rehabilitation Department.

To assess risk of stroke for yourself or a loved one, click on Men's Stroke Risk Assessment, Women's Stroke Risk Assessment.

Mercy staff provide physical rehabilitation  services for stroke recovery.

For more information on strokes, click on www.strokeassociation.org.